Surgical intervention in skull fracture
1. contaminated, deformitiy
2. impingement on cortex
3. open fracture, CSF leak

ICP monitor indication: GCS < 9

indications of urgent surgery for veterbral fracture
1. not complete spinal cord injury
2. for decompression ( extrinsic compression or hematoma)
3. prevent for future compression ( unstable vetebrae)

Methylprednisolone 30 mg/Kg in 1st hour
Methylprednisolone 5.4mg/Kg in next 23 hours

Scaral sparing:
1. anal tone, perineal sensation
2. toe reflexion @@"

有人名的Fracture
Hangman's fracture: C1
Hangman's fracture: C2
Odontoid fracture: need open mouth view
type 1: tip
2: base
3: fracture through vetebral body

Chance fracture: transverse vetebral fracture
Clay shoveler's fracture: fracture of spinal process of C7